University of Oulu

Koskinen, J. S., Kytö, V., Juonala, M., Viikari, J. S. A., Nevalainen, J., Kähönen, M., Lehtimäki, T., Hutri‐Kähönen, N., Laitinen, T. P., Tossavainen, P., Jokinen, E., Magnussen, C. G., & Raitakari, O. T. (2023). Childhood dyslipidemia and carotid atherosclerotic plaque in adulthood: The cardiovascular risk in young finns study. Journal of the American Heart Association, 12(7), e027586.

Childhood dyslipidemia and carotid atherosclerotic plaque in adulthood : the Cardiovascular Risk in Young Finns Study

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Author: Koskinen, Juhani S.1,2,3,4; Kytö, Ville1,2,5; Juonala, Markus1,2,3,6;
Organizations: 1Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
2Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
3Division of Medicine, Turku University Hospital, Turku, Finland
4Department of Medicine, Satakunta Central Hospital, Pori, Finland
5Heart Centre, Turku University Hospital and University of Turku, Turku, Finland
6Department of Medicine, University of Turku, Turku, Finland
7Faculty of Social Sciences, Tampere University, Tampere, Finland
8Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
9aculty of Medicine and Health Technology and Finnish Cardiovascular Research Center Tampere, Tampere University, Tampere, Finland
10Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
11Tampere Centre for Skills Training and Simulation, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
12Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
13Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
14Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
15PEDEGO Research Unit, University of Oulu, Oulu, Finland
16Department of Pediatrics, University of Helsinki, Finland
17Hospital for Children and Adolescents, Helsinki University Hospital, Helsinki, Finland
18Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
19Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: John Wiley & Sons, 2023
Publish Date: 2023-09-22


Background: Childhood exposure to dyslipidemia is associated with adult atherosclerosis, but it is unclear whether the long‐term risk associated with dyslipidemia is attenuated on its resolution by adulthood. We aimed to address this question by examining the links between childhood and adult dyslipidemia on carotid atherosclerotic plaques in adulthood.

Methods and Results: The Cardiovascular Risk in Young Finns Study is a prospective follow‐up of children that began in 1980. Since then, follow‐up studies have been conducted regularly. In 2001 and 2007, carotid ultrasounds were performed on 2643 participants at the mean age of 36 years to identify carotid plaques and plaque areas. For childhood lipids, we exploited several risk factor measurements to determine the individual cumulative burden for each lipid during childhood. Participants were categorized into the following 4 groups based on their childhood and adult dyslipidemia status: no dyslipidemia (reference), incident, resolved, and persistent. Among individuals with carotid plaque, linear regression models were used to study the association of serum lipids with plaque area. The prevalence of plaque was 3.3% (N=88). In models adjusted for age, sex, and nonlipid cardiovascular risk factors, the relative risk for carotid plaque was 2.34 (95% CI, 0.91–6.00) for incident adult dyslipidemia, 3.00 (95% CI, 1.42–6.34) for dyslipidemia resolved by adulthood, and 5.23 (95% CI, 2.57–10.66) for persistent dyslipidemia. Carotid plaque area correlated with childhood total, low‐density lipoprotein, and non–high‐density lipoprotein cholesterol levels.

Conclusions: Childhood dyslipidemia, even if resolved by adulthood, is a risk factor for adult carotid plaque. Furthermore, among individuals with carotid plaque, childhood lipids associate with plaque size. These findings highlight the importance of primordial prevention of dyslipidemia in childhood to reduce atherosclerosis development.

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Series: Journal of the American Heart Association
ISSN: 2047-9980
ISSN-E: 2047-9980
ISSN-L: 2047-9980
Volume: 12
Issue: 7
Article number: e027586
DOI: 10.1161/JAHA.122.027586
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The Young Finns Study has been financially supported by the Academy of Finland (322098, 286284, 134309 [Eye], 126925, 121584, 124282, 255381, 256474, 283115, 319060, 320297, 314389, 338395, 330809, 104821, 129378 [Salve], 117787 [Gendi], and 41071 [Skidi]), the Social Insurance Institution of Finland, Competitive State Research Financing of the Expert Responsibility Area of Kuopio, Tampere and Turku University Hospitals (X51001), Juho Vainio Foundation, Paavo Nurmi Foundation, Finnish Foundation of Cardiovascular Research, Finnish Cultural Foundation, Tampere Tuberculosis Foundation, The Sigrid Juselius Foundation, Emil Aaltonen Foundation, Yrjö Jahnsson Foundation, Signe and Ane Gyllenberg Foundation, Diabetes Research Foundation of Finnish Diabetes Association, EU Horizon 2020 (755320 for TAXINOMISIS and 848146 for To Aition), European Research Council (742927 for MULTIEPIGEN project), Tampere University Hospital Supporting Foundation, Finnish Society of Clinical Chemistry and the Cancer Foundation Finland, Maud Kuistila Memorial Foundation to Koskinen, Päivikki and Sakari Sohlberg Foundation to Koskinen, Finnish Medical Foundation to Koskinen, Paulon Foundation to Koskinen, Licentiate of Medicine Paavo Ilmari Ahvenainen Foundation to Koskinen, and a National Health and Medical Research Council Investigator Grant (APP1176494) to Magnussen. The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of the National Health and Medical Research Council.
Copyright information: © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.